Making Use of Winnicott: A Roundtable Discussion

by
Murray M. Schwartz

September 9, 2009

The transcript that follows records a day-long discussion of the work of D.W. Winnicott that took place in New York on March 24, 2007. The roundtable discussion consisted of four presentations, followed by responses from the presenters and the audience. Because Winnicott has been and continues to be so important to the psychoanalytic exploration of literature and the arts, I have taken the editorial privilege of requesting permission from the National Institute for the Psychotherapies to reprint the transcript in PsyArt. I wish to express my gratitude to Sheila Ronsen and the Editorial Board of Psychoanalytic Perspectives: A Journal of Integration and Innovation, for permission to publish the rountable discussion online. It first appeared in Psychoanalytic Perspectives, Volume 5, Number 2, Summer 2008.

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SHEILA RONSEN: Hello. I’m Sheila Ronsen, the Associate Director of Continuing Education at N.I.P. and the moderator of this Roundtable. I want to welcome all of you here today. Let me introduce our roundtable presenters. Dr. Fayek Nakhla is a psychiatrist and member of the British Psychoanalytic Society. Dr. Elsa First is a child and adult psychoanalyst and a supervisor and faculty member at New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. Dr. Judith Kuspit is a psychoanalyst on the faculty of the Institute for Contemporary Psychotherapy and the Psychoanalytic Psychotherapy Study Center in New York City and Dr. Murray Schwartz is a Professor of Writing, Literature and Publishing at Emerson College.

I would like to begin by setting a sense of space, which was an integral part of my original conception of this roundtable. I saw it as a playing space .Paraphrasing Winnicott, I use the verb ”playing” rather than the noun ”play” to give a notion of things in process, active and becoming versus finite and foreclosed; a place where Winnicott's ideas could be presented and made use of by all of us under the sway of our own personal idiom, as Christopher Bollas might say. Each presenter has created and found in Winnicott's work something of meaning, something that led to a passionate and enduring engagement which they will be sharing with us today. I hope that this day affords us all some surprises, an occasion for discovering what was already there to be found.

We’ll first hear from Fayek Nakhla.

PRESENTATION BY DR.FAYEK NAKHLA

Sheila reassured me as she held my hand that we are going to be playing. And so hopefully, play areas will overlap and from that, some productive learning experiences will be created. I'm going to be talking about one of Winnicott’s major contributions- his concepts of the true and false self. There's nothing new about the central idea of the false self. Others have talked about it in many different forms: philosophers, poets and certainly Helena Deutsch's paper “The As-If Personality” and R. D. Laing's, alienated self in his book The Divided Self. But the significance of Winnicott's contribution to the false self is the way he conceptualized the etiology of that illness and also its consequences for clinical analytic work. He regarded the false self as an illness resulting from early environmental failure. Winnicott developed a model of early emotional development, the center of which was the maternal environment. Embedded in that model are his ideas of trauma or environmental failure or the impingement of the environment, which he talked about in a general way as the not “good-enough mother”. The maternal function of holding is what facilitates the integration of the ego. The infant also, from the very beginning, has spontaneous gestures which are object-seeking. Right from the start, the first contacts are object-seeking. These are expressions of the potential true self. The maternal response to those object-seeking gestures he referred to as object-presenting. The “good-enough mother” meets these gestures in total adaptation to her infant’s needs and she makes sense of them . She does this repeatedly and this develops for the infant a sense of omnipotence. The mother that's being sought or the world that's being sought is felt to be created by the infant. Winnicott refers to this as the subjective mother. Before the reality of the “me” and the “not-me” and what then becomes the objective mother, the separate mother. He regarded that experience of omnipotence or the illusion of omnipotence as the basis for health. Unlike Freud, who regarded all the forms of illusion as a defense against reality. That creativity -- creating the mother, obviously leads to the creation of the transitional object and transitional phenomena and a whole area of creativity which obviously is another big area for Winnicott. The not “good-enough mother” does not meet these gestures in the way I've described but instead substitutes her own gesture and the infant makes sense of that by a reactive compliance. This is the earliest stage of the false self. The true self, even at the very beginning, is in a state of existing or being where there's an outward direction, which has meaning and life, while the false self is in a state of being where there's a compliance, a reactive compliance with no sense of aliveness or meaning.

The function of the false self is to hide and protect the true self, which is always potentially there. Winnicott regards that in every individual there is a split of a true self and a false self. He described a whole range of the false self organization. At the pathological extreme is when the false self presents itself as the real person, where the true self is completely hidden. Obviously, in such individuals, they will have enormous difficulties in every type of relationship interaction because of an essential lack of the true self there. At the healthy end of that spectrum or range in health, the false self is what we would present as our social self, our polite social self, our polite manner. That is an achievement. Obviously, the issues around which we comply in our social manner are not crucial, but that capacity also helps individuals fit in socially and respond appropriately. Within that range and moving towards the pathological, the extreme pathology end, is where the true self can be hidden by the false self, but it has in that split a secret life, a private life which the false self protects. You see that kind of clinical picture in a severely schizoid individual. Then within that range moving towards health, there's that split. And the disturbances, the clinical manifestations of this is for the true self to come more into its own. The clinical picture here can be very varied, depending on the struggle, from mood disorders, wrist cutting, enormous interpersonal issues and so on. The function of the false self in that clinical range is to search for conditions where the true self can come more into its own. If there's doubt that conditions will occur where the true self can come into its own, you could get suicide at that point. That suicide is not just a depressed person committing suicide but it's the defense of the true self against feeling totally exploited or the threat of its being totally annihilated.

I'm going to present two cases to highlight how each patient experienced that split of the false self and true self. The first case is from my book Picking Up the Pieces,[1] which I co-authored with a patient I call Grace. In that book, in alternating chapters, we describe the first three and a half years of a treatment which lasted 16 years. The writing, obviously, occurred at the end of the treatment.

In the first 18 months of a once a week treatment Grace was almost completely silent. This went on week after week. She was visibly distressed, sitting on the edge of the chair and so on. She describes her distress in a letter she sent to her former analyst in London- Dr. P.- which I will read from. Two months into our treatment she writes: ”Dr. P.- I've been seeing Dr. Nakhla and mostly we have been talking (or not talking)about why I cannot talk to him... An old pattern; but relived each week with such intensity that when I leave I think my head will split and I don't want anything to do with any person in the world. I don't know how I feel about him: when I'm there, I mostly feel terrible as if I'm involved in a hopeless struggle; but the hopelessness is real and true as almost nothing else is: in that sense, it is good- I guess I believe somehow it's not infinite or I would just have to kill myself, metaphorically or otherwise.” [2] She then goes on to tell Dr. P. how she's been settling down in New York and her life in New York. She writes: “The days have become well-patterned; I make my way easily through them. When I stop to look at myself, with thousands of other commuters, sitting all day in the office, clearing my desk at 5 to go home, I am surprised at the ease, the familiarity with which I deal with everything; it gives me a sense of accomplishment, but it's unreal, it doesn't mean anything; I am untouched. I am seeing that I can survive the world, and that, I guess, is a necessity, but between that and me is an awful space.”

A year into the treatment she sends me a letter when I'm on vacation and I'm going to read a few lines to highlight what she is feeling. She writes: “I truly do not believe that I am real. I am a shadow.” And then a couple of lines later she says: “ There is no separation of real and unreal, internal and external, no conflict as I always thought: for nothing is allowed existence, allowed birth into the world. I feel naked; some form called Grace takes up space... No wonder I never talk.”[3]

The second case I’ve selected goes all the way back to my analytic training years in London in the mid-1960s. This was my second control case. I saw this patient, as required, five times a week and the treatment went on for a bit over two years. The analysis went very smoothly. No problems. The patient talked, free associated, produced dreams. I analyzed, interpreted. I went to my weekly supervision, my supervisor was satisfied.(group laughter) The training committee was satisfied and I was qualified. Now I did sense -- even though in your control case you want everything to go smoothly as much as possible, but I did sense that there was something off. There was kind of an emotional shallowness. He would walk in, walk out, perhaps never take even a good look at me. There was something strange. But I went along with it. I did mention that to my supervisor and I must say I did make some attempt, which I won't go into, to try and touch on that. But after I was qualified, I became a bit freer to be myself and I had the patient sit up. And even though I sensed something was amiss, I was still shocked when he sat up and said, “ I know I've been coming here every day for the last two years, but if you tell me this never happened, this is unreal, never happened, that's exactly the way I feel.” I mentioned before Winnicott's contribution to the etiology of the false self ,its development and its consequences for analytic clinical work. Winnicott saw and emphasized the futility of the analysis which goes on within the false self and how the patient and analyst can collaborate indefinitely- a futile collusion between the two. Certainly, this is what happened in my control case. I think what contributed in terms of the collusion from my end, was my excessive compliance. When one is a training candidate -- you know, you don't want to rock the boat. And this actually has been described in various publications as the false self of the training candidate. Apparently, it takes years for the analyst in training to -- maybe ten years -- to really develop his own style and identity.

Another point Winnicott makes about working with the false self is that the analysis only starts when there's direct contact with the true self. Winnicott gave examples of how he made that direct contact. For example, he has said to patients, “You have not started to exist yet”, or he quotes a patient telling him, “The only time I felt hope was when you told me that you could see no hope and you continued with the analysis.”[4] It's hard to tell a patient I see no hope, but—With my patient Grace I certainly could have made direct contact with her true self. I mean, she was very explicit about her non-existence or when she says the hopelessness is terrible but it's “real and true as nothing else is.” Certainly her silence is an expression of her true self. I mean, at that time I was trying to get her to talk and talk . But obviously, I didn't know how to do it [i.e. see expressions of true self and make contact with it ] then. Winnicott warned analysts/therapists that when you make the transition to contacting the true self it is usually followed by a prolonged process of dependency and regression and from what I've also seen–there’s some anger and destructive feelings. I did ultimately make that transition with Grace.

Finally she came into a session and had a psychotic breakdown. She had the feeling of not being connected to her body and because I’d been struggling for 18 months not knowing exactly what's going on, I decided to put her in the hospital. I held a position in the hospital and so could be in charge of her treatment rather than somebody else taking it over. I think I made a connection there, finally. I'm going to read what Grace described about a bit of a session which occurred soon after she was discharged from the hospital. She came to a session with a big pot. You know, when you're in the mental hospital you make pots and drawings and things like that. She made that pot there and the pot was filled with shredded newspaper. Apparently, she had been shredding The New York Times all weekend and putting it in that pot and she came here and presented me with that. She writes about that experience: “He,” meaning me [FN], “He pulled out the newspapers, threw them on the floor.” “That really is you,” he said . I pick up the paper from the floor, tear it into smaller and smaller pieces. “Yes, I'm giving the pot to you,” I said. “I made it myself.” “I think I will take it home and put flowers, not newspaper in it, “ he says. I am holding on to him. “What can you do with these shreds?” I ask. There was newspaper all over us. “That's how you feel- uncontained by the pot, the shiny surface. You know, I don't really like that pot; it reminds me of the empty you.” I look questioningly at him : can I? He nods yes and I throw it. I never thought I could destroy anything I made; I could be careless, but never deliberately, consciously destroy. “It gives a kind of hope”, key word here -- ”that I can destroy the unliving, self-containing part of myself;” -- her false self, ”but at the same time, is the fear that having once begun I will be unable to stop destroying.” [5]Actually, the treatment that followed was very violent with endless wrist cutting, horrendous.

SHEILA RONSEN: Okay Fayek.
FAYEK NAKHLA: Can I take two minutes? No?
SHEILA RONSEN: We’ll come back and you’ll have an opportunity to say more.
FAYEK NAKHLA: Okay. I think the thing that I’ll be mentioning then is..(group laughter)
SHEILA RONSEN: I think I have to bear my destruction. (more group laughter)
FAYEK NAKHLA: I’m just going to tell them what I missed. It’s how the mind can also be an aspect of the false self. And we’ll have a chance of bringing that up later.
SHEILA RONSEN: I promise. Now we’ll hear from Elsa First.

PRESENTATION BY DR.ELSA FIRST

What I thought I would do is focus on the first four sessions of The Piggle[6] because that’s the point at which Piggle becomes able to play and Winnicott, himself, in his marginal notes comments that he realizes that before this she was in it and not able to play it. She was in it like a psychotic child.[7] You may remember Piggle in the first consultation was two years four months, something like that . Winnicott saw her on-demand. I think it was her mom’s demand. She must have felt terrible to find that when the second child was born, it was kind of an unplanned conception, and I think it affected the mom very much that she had been a bad mom to Piggle. And Piggle became very unlively and stopped being herself and would only be the baby or the mother, which we see kids do. She also developed a kind of delusional construction, a kind of delusional symptom that she would have at nighttime about a black mummy, but mummy is mommy. A black mummy who would come and want to steal her yams, which were her breasts that hadn't grown. There was also a “babacar” [Piggle’s representation of her mother’s womb] which was taking blackness from me to you, and it became a whole obsessional system that the family complied with with this sort of extra intensity and concern and a kind of inability to normalize it, which is part of what Winnicott perhaps provided. Little Piggle was primed that Dr. Winnicott in London probably knew about babacars and could explain them to her. So that's the back story.

But before beginning, I thought -- since we're allowed to play around a little bit—It's very funny coming back to this material which was published in the mid '70s. Winnicott worked with Piggle in the mid '60s when Fayek and I were both training in London and hearing about Winnicott, not being allowed to have direct contact with Winnicott, but getting all the secondary we could. The Piggle, itself, is posthumously published. It’s a very elegiac kind of text because it wasn't written for publication, but here's Winnicott at 68 and Piggle at 2 encountering each other which leads me to say about what is real and true... Well first, I'm saying now we're looking back on it 30 years later and realizing how much we've taken in of it and been working from it ,how much the field, in its interest in intersubjectivity and mentalization and people understanding each other, has come along to see these things as salient, which weren't salient at the time that they were to Winnicott. In moments of meaning or whatever.

But before reading the beginning, because of Fayek, I want to read something of the end because it marches so well with what you [addresses FN] were reading. This brings us to the very end when she destroys Winnicott and it brings us into bigger questions of what did he mean by transference and what is the therapeutic situation.

I know what the thought was that I just almost lost- it was something about ordinariness, because there's always a dialectic in Winnicott between the ordinary; and then I wonder the ordinary and what? Because it's not quite the special, you know. It's something happening. It's the ordinary and the discovering, maybe. The ordinary of the setting of your frame of mind as the therapist. You're not in there to make something marvelous happen or to put in your brilliant interpretation. You're there to let out of the ordinary some discovery happen.

I want to go to the end of Piggle which involves a lot of stuff about destruction and Winnicott's idea of the transference at that point because he was letting Piggle show him what he was thinking. And someone said - it's in Adam Phillips' book- it wasn't just that Winnicott understood children. Children understood Winnicott.

So I have a quote here, before we go to the end of Winnicott- what’s my stopping point because I didn’t notice my starting point?

ELSA FIRST: This is from Nikolaas Treurniet the Dutch analyst, who wrote a wonderful paper maybe ten years ago about what is psychoanalysis today.[8] He says the post classical analyst we now think of as a new and an old object at once. “The analyst then becomes the new object with whom the trauma is experienced in a new context. The trauma has, after all, subjectively occurred but it has never been experienced. It has happened but has, at the same time, not yet emotionally happened.”[9] So that's what we now think of as the transference situation. Right?

So here's the end of ThePiggle, the 15th consult. For those of you who don't know, she came in roughly once a month, sometimes there were a few longer intervals when he couldn't see her. And she asks for the roller, a game they play in which something like a rolling pin goes back and forth and it's a version of a hide and seek game, but when the roller hits you, you're dead and you disappear. Winnicott writes, “...starting off by her killing me. Then I killed her and hid for her to find. I said she was letting me know that she forgets me and that I forget her when we are apart or on holiday, but really we know we can find each other.” [10] She's now over four. And then she flirts with him and then she sings a sarcastic version of Good King Wenceslas which makes fun of doctors. This is a little bit her false self coming in, you know, the school kid who knows all this stuff. And then she starts drawing. He says, “...it was as if she were drawing to show me a dream, and some of the dream had spilt over into waking life. It seemed that this was what she wanted, for she now told me a dream. ” Of course, he was very good at cueing in to that level when he thought the time was there. “...and it felt as if this was perhaps what she had come to tell me.”[11] So Gabrielle, Piggle is now enough of a separate person that she's acknowledged as Gabrielle not Piggle when she was the object of the parents attributions and projections. She then tells Winnicott about a dream she had in which Winnicott is in the pool in his garden. Piggle dives in and her father sees her hugging and kissing Winnicott .Then her entire family, including all her grandparents dive in and join them. His notes to himself are, “I felt that she had now brought everything into the transference and had in this way reorganized her entire life in terms of the experience of a positive relationship to the subjective figure of the analyst, and his inside.”[12] Now he doesn't say that. What he says is, “The pool is here in this room, where everything has happened and where everything imaginatively can happen.”[13] And she says something about her hands are wet because she's swimming, which we would take as an affirmation. A bit later on, Piggle is playing with a little toy man, twisting his legs and generally ill treating him. Winnicott says, “Ow, ow, [as an interpretation of acceptance of the role assigned to me.]” She continues in her twisting the figure and Winnicott plays along as Piggle tells him to cry more. Finally, very pleased with herself , having removed the figure’s leg and head, she announces, “ Now there's nothing left..........I am throwing you right away. Nobody loves you.” “So Susan [her baby sister] can never have me,” Winnicott says. “Everybody hates you,” Piggle responds.[14] And then she repeats this thing and so on. And in the middle he says, “ So the Winnicott you invented was all yours and he's now finished with, and no one else can ever have him.”[15]And Gabrielle says, “ Nobody will ever see you again. Are you a doctor?” “ Yes. I'm a doctor and I could be Susan's doctor, but the Winnicott that you invented is finished forever.” And she astonishingly says,“I made you.” [16] So that fits with the end of your(addresses FN))thing.

FAYEK NAKHLA: She [Grace] created me.

ELSA FIRST: So now I'll go to the beginning of Piggle. My cutoff point then..I’m sorry to keep being anxious about this , but at 10:10 I had 12 minutes so that takes me to 10:22.

SHEILA RONSEN: Make it 10:26 and we’ll split the difference. (group laughter )

ELSA FIRST: I'm going to read snippets which reveal his contacting her anguish and not being able to be with the experience of the new baby coming and what it has done to her relationship with the parents. But also to track the theme of what Winnicott then called cross - identification, of her learning to put herself in the place, in the mind and the feelings of the others and to realize that others could put themselves in her place. That's the cross at which he felt was ,I think , inextricably connected with the capacity for symbolic role play. It's in The Piggle that you see it happening.

In the first consultation we see in Piggle’s play her struggle with the birth of her sister Susan when Piggle was a baby herself. She tells Winnicott about her frightening dreams about the babacar. Several days after the consultation Piggle’s mother calls Winnicott and tells him that Piggle allowed herself to be a baby instead of her constant protest. She also said that the teddy bear, that was part of the play in the initial consultation with Winnicott, wanted to go back to London to play with Dr. Winnicott but she didn’t want to. It was the beginning of the capacity to represent ambivalence. Not a bad thing. At home Piggle would suddenly look and say “the babacar” and all would be spoiled. Winnicott said that this was an indication of the introduction of hate or dissolution into the play.

In the second consultation the Piggle asks Winnicott if he knows about the babacar. He is not quite daring to be Winnicott yet. He takes a risk and interprets that it is the mother’s inside where the baby is born from. “She looked relieved and said , “Yes, the black inside.”[17]

In the third consultation Winnicott refers to material from the prior session in which Piggle overfilled a bucket with toys and talked to Piggle about it in terms of making a baby by filling up the bucket out of greedy eating. Her emptying out the bucket is her throwing up. He's talking about this as being sick. Sick means to throw up, nauseous in England. And he says -- this is the famous place where Winnicott plays before Piggle plays. And if you ask beginners in psychotherapy training, you know, what do they know about this case, they will say that, yes, Winnicott played. He didn't wait for the material. It's a very poorly assimilated notion of where he was that he allowed himself to play with this child who couldn't yet play.

The play goes on and we see Piggle struggling with issues of where babies come from and her desire to be the only baby. After much repetition of this play Winnicott states that the child has to play with pleasure before it can be understood and interpreted. Piggle says, “I am just born. And it wasn’t black inside.”[18] Winnicott writes that , “She had now developed a technique for being the baby while allowing me to represent herself.”[19]It’s in the third consultation that Winnicott realizes that before that she had been in this blackness and babacar thing as a psychotic child, that it was real. She is now playing at it rather than being in it. She is also beginning to be able to sort out that her dreams are not just another reality she’s embroiled in, in a persecutory way, but it's a dream she's having at night .

I’ll go on to the fourth consultation where the cross-identification is fully realized. The session ends where Winnicott stays on the floor where he was, but I think Piggle, we hope, understands the two roles that Winnicott is playing and how they overlap or reverse each other. ‘I stayed where I was being the black angry mummy who wanted to be daddy's little girl and was jealous of Gabrielle’-- this idea came from her when she says a little earlier in the session: “Mummy wants to be daddy's little girl.” ‘At the same time I was Gabrielle being jealous of the new baby with mother. She ran out the door waving and saying, “ Mother wants to be daddy's little girl.’[20] So the anguish about exclusion, about triangulation, about wanting to be the only one. Gabrielle can now understand that as something she feels towards the baby and that mummy may feel towards her. And at this point, everything becomes playable.

SHEILA RONSEN: So nobody's excluded.

We’ll now give Murray and Judith an opportunity to respond to Fayek and Elsa’s presentations.

RESPONSES TO FAYEK NAKHLA AND ELSA FIRST BY MURRAY SCHWARTZ AND JUDITH KUSPIT

MURRAY SCHWARTZ: I want to put in a good word for the false self. Because, as others have pointed out, it can be a little misleading to talk about true and false in this context. And I think you each made allusion to the way in which the false self is a necessary part of living in society and growing up in a way that can accommodate other people. But I think that there's something even more positive in this feature of development that Winnicott was quite aware of and that sometimes gets obscured by the need to focus, in therapeutic contexts, on the precarious condition of the true self. Winnicott, with his genius for language, gave us room for this when he talked about a “good-enough mother”. So much of his vocabulary responds to a kind of polarizing tendency. Good breast, bad breast becomes “good- enough mother”, which means that part of the function of the mother is to educate the child into some interplay of true and false selves.

One of my granddaughters is four years old and she likes to call my wife just about every day on the telephone. And of course, she's very brilliant and verbal. And one night she called and she said, “What are you doing?” My wife said, “ We're about to sit down to supper.” My daughter keeps a semi-kosher house. So she said, “Well, what are you eating?” And my wife said, “We're about to have fish.” She said , “I don't like fish.” And my wife said, “Well, why don't you like fish?” She said ,“Fish is pork.” (uproarious group laughter) That's one of the things I mean by the value of the false self. It's a way of learning, not just compliance, but what we might call role playing. Not just fitting in, but negotiating a space for one's self that makes for a personal interplay of true and false, spontaneous and compliant. Because after all, she's trying to figure out these categories which she didn't invent but which have been, in a sense, imposed upon her. They are the world's gestures to her. But she's doing it in a way that we can see as quite playful and potentially liberating because she's not stuck in that state of compliance.

I think we saw a version of that in this negotiation over the time limit. (group laughter) In other words, the false self can be a way, if it's in a flexible interplay with spontaneity and the true self , of negotiating very rich social relationships. I just want to say a word in its favor.

JUDITH KUSPIT: I love that idea of the false self as a way of learning to negotiate . These two papers for me are subjective objects at this point. I'm sort of imbibing them. They are like a good drink. And so let me give you some of my free associations in relation to these papers.

One is a remark that was made by Masud Kahn that “I am false to my back teeth.” [21] That, in a fifteen year analysis with Winnicott, he only had three experiences of true self. All three were physical. That is, that he found himself on his knees with his ear to Winnicott's heart and he listened to it. So there was a psychosomatic collusion at those moments that was not present at any other time. At one point in another treatment in Holding and Interpretation[22]Winnicott says something to the effect “Get the nurse of the false self out of the room.” That we talked as if we were two nurses talking about this child when he was talking about the patient.

I love your (addresses FN) bringing up the idea of a training case and the issues that come up. Winnicott, in one of his articles, uses a marvelous metaphor for what happens in some treatments and he's talking about psychotic treatments. He uses the idea that there are some analysts who have a psychotic fish on a long fishing line and they just keep on letting out the line year after year; and I think that, in some sense, we find in training cases all kinds of collusion that goes on in terms of negotiating and relating to the false self. The idea of suicide and hopelessness and Winnicott's ideas were well known, I think, in relation to suicide. He wanted patients to suicide for the right reasons. It's not always clear. He did have patients who suicided. So I was interested in the fact that you (addresses FN) brought it up.

In going back to Kahn, as I said, who was “false to his back teeth”, the false self had multiple selves. So there's a shifting shape in the idea of the false self that seems to be very, very protean, protean in terms of the way it shows up in various situations. And I like your (addresses MS) idea about the negotiation. That's so important in relation to the false self.

MURRAY SCHWARTZ: One of the things that I might be able to contribute here are some examples from literature. If you think of Winnicott's idea of suicide, you find a lot of examples in Shakespeare alone. Cleopatra's suicide fits precisely with the notion of protecting a true self from being exploited. She celebrates her death because that's its value to her. Roman suicides had the same form. They're requirements, if one wants to be a Roman man, you commit suicide rather than become exploited on a number of levels. So that can be useful.

I have a question for Elsa. At the beginning, you used a word that really struck me as really quite fascinating. You called The Piggle an elegiac text. Can you say some more about that?

ELSA FIRST: It's suffused with a sense that Winnicott is aging and will soon

die. As Piggle goes from two to four and begins to understand that London is far from Oxford or Cambridge, wherever it was that she came from, she says, “Did you hear the nightingale? It's a pity you moved so far away.”[23] Because she's just getting the fact of time and distance and mortality and duration. And when she talks about his birthday, he brings it to his death day. The idea of his death day. So in that sense I think it's elegiac and there's a lot of space in it, like in late works.

MURRAY SCHWARTZ: So you sense a kind of melancholy?

ELSA FIRST: I think so.

JUDITH KUSPIT: It's interesting, the elegiac aspects of this case. And I was interested in reading a description by Joyce Coles [Winnicott’s secretary] about how he came out of the room after being with the Piggle red - faced, absolutely disheveled and having difficulty breathing. And he would immediately write his notes up after that time.

And I've always been interested in just the idea of his death day and asking a child about your death day. His idea about death, which it took him a long time to get to work through, and that is , “May I be alive when I die”,[24] and what he writes after that; because I think at the same time we get a sense of potential space at death which is very important to him in life. I think the American ear also hears Emily Dickinson, “I heard a fly buzz when I died.” [25] If you contrast it, it's not a negative contrast, it's just a different situation. I think of Freud who was reading Balzac’s The Ass’s Skin and says, “It’s no accident that I’m reading about a shrinking ass skin as I’m dying.” You don’t see the shrinking ass skin exactly in Winnicott but you do see the potential space.

FAYEK NAKHLA: When I was reading The Piggle, I really couldn't get into it because I don't work with children. But still I found the whole engagement reminded me of the squiggle kind of game. I mean, I've seen Winnicott demonstrate the squiggle and even when Winnicott said that he starts to play first, it's like with the squiggle, he draws something first and he engages the other one. In The Piggle ,like in the squiggle, it seems so dream-like, the way he gets into this primitive way of connecting.

The other thing which I don't know if you (addresses EF)want to comment about is the way the he also played with the parents.

ELSA FIRST: I think he was holding both parents, actually. He was holding the mum's intense anxieties about having harmed this child and because of whatever her difficulties were in being with her; because she could then use her anxious scrutiny of the child to good effect in keeping track for Winnicott. And in their idealization of Winnicott as a good mother/father who could understand about babacars. I mean, they were able to use him as someone who represented the idea that there is good parenting in the world. There is good understanding. There is good normalizing. There is good acceptance of the darkness without feeling too frightened or guilty.

FAYEK NAKHLA: The other thing was these sessions on demand. He even made the comment, I think, it's better than these weekly sessions.

ELSA FIRST: I don't know if I want to comment on that. Only because I was just reading Dodi Goldman, who speaks of Winnicott's own grandiosity at times and times that Winnicott felt that an ounce of Winnicott is worth a pound of somebody upstate.[26]

FAYEK NAKHLA: He sometimes felt that the patient needed two hours, three hours instead of 45 minutes.

ELSA FIRST: He was that.

FAYEK NAKHLA: That's Winnicott.

ELSA FIRST: There's something else I wanted to respond to in your [addresses FN] comment about the playing. He wasn't playing any old thing. He wasn't negotiating any old thing. He let there be these times of muddle and false self and Piggle would come in singing , “I was reading ‘Everybody’s’,” a magazine. She would be full of all this chatter of the kid who's picking up, you know, the commercials. And he didn't do much with that. He wasn't ready to pounce on everything. But he had a sense of what the deep stuff was.

I have a bit of a quarrel that I've just been developing with some of the people in the Boston Change Group like Karlyn Lyons-Ruth who has a wonderful, wonderful paper about playing as the child is learning to negotiate what is acceptable and shareable with other minds. Then I found that one of the people she quotes from Anthology on Play ten years earlier, makes a point that all Winnicott was doing was teaching people to play and it really didn't matter the content. It really didn't matter what he said. And there's a trend in this direction, thanks to Winnicott, in a way. The mutuality of play and what play does in terms of enhancing your understanding of the subjectivity of others and their understanding of your subjectivity, all that's there. So there's a little bit of what we used to call positivism. It doesn't matter if you're talking about dark babacars or Superman or something. I think if you look in Piggle, the moments that are change moments, he is in touch with her darkness. And she knows it. So it's not as if you could just play about anything.

FAYEK NAKHLA: If I can make just one point. I think Winnicott would object to your using the word teaching her how to play. He would say he would do something which would then allow her to play.

ELSA FIRST: Oh, yeah.

FAYEK NAKHLA: He resented teaching. Sorry.

ELSA FIRST: No, I'm quoting other people who say that's what Winnicott did. He gave her play skills.

MURRAY SCHWARTZ: At the beginning, I thought you (addresses EF) raised a really fascinating question : What's the missing word? The dialectic between the ordinary and what's the word? I think I started to think or associate to that. What word can we put there ? I think one of the words we might put there is gravity. That is to say, the ordinary and its gravity. The ordinary gets weight in Winnicott. He says ordinary things, but they have a kind of gravity to them. They begin to matter. Even though they seem so obvious and simple and sometimes he even calls them superficial, they begin to assume a gravity that we might have taken for granted or may be not even noticed at all.

ELSA FIRST: And the gravity does not come particularly from the fact that they are representing a privileged theory.

JUDITH KUSPIT: I will just make a few remarks on some of the remarks that have been made. I think of something that Charles Rycroft said about Winnicott. He referred to him as a crypto prima donna. I think it's unfair, but it picks up a dimension of a kind of ruthlessness and an absolute insistence on the nuisance value of his own creativity. Very important. It's there. I mean he's absolutely fierce and there's an extraordinary discipline. When he does something, you get a sense of a discipline. It's very much like reading Ferenczi's Clinical Diary. You know there's a rigor and a tension behind that that ballasts it in the way that you talk about gravity. I remember somebody talking about play and saying we're not talking about light. We're talking about something that's deeply serious. So that's an important piece of it. As well as his having as a goal a kind of tamed omnipotence. There is also a dialectic between a Christ identification in here. A humility that is very, very important as well as the tamed omnipotence and the brilliance of an ordinary language, ordinary experience.

What I thought about was Wordsworth’s part of the lyrical ballads because much of this comes out of a Romantic sensibility; that is, a heightened sense of subjectivity .In Wordsworth's lyrical ballads he's using ordinary language, speaking of ordinary people and it gets transformed through imagination. The “willing suspension of disbelief” gets transformed into something quite other.

When Winnicott talks about squiggling , and I've never done squiggling with a child patient, it's fascinating. One of the things he says is that he’s better at it than the child. Then he says, the child is reluctant because they're afraid of incontinence. That raised something for me working with adults. You see almost literal fear of mental incontinence. If you want to think about free association and if we think about squiggling with the adult, it's kind of bilateral mutual play, but what exactly is it? Grolnick said it's like a tennis game. It's not exactly clear.

SHEILA RONSEN: We’ll take a break now and when we return we’ll hear from our other roundtable participants: Judith Kuspit and Murray Schwartz.

PRESENTATION BY DR.JUDITH KUSPIT

I just want to raise some points about Winnicott. These are just notes towards a trilectic of creativity, destructiveness and madness. Winnicott says, and he's quite explicit about this, if I believe in primary creativity and there's creativity, destructiveness is right next door.[27] It's right there. Then madness sort of weaves its way in and out, like flotsam. And to use Michael Eigen's idea [28], one has to, when one works with patients, to sort of befriend one's own rhythm of madness. In Winnicott, too, there are continual spontaneous curings that are going on in these spots of madness in the treatment. So I'm very interested in this trilectic and I haven't worked it out fully.

Let me just say that in Winnicott's theory of primary creativity, everybody has the capacity for it. He insisted upon that. It reifies in 1952 in a review that he did with Masud Kahn, who was his patient. The two of them write a review on Fairbairn [ Fairbairn’s book, Psychoanalytic Studies of the Personality ] and they kick the guy in the North and what they say is that he doesn't have enough Dire Mastery in relation to Freud. He's not Freudian enough. That's number one. Number two is that his theory of creativity has nothing human in it. It's all about projection and introjection. What they say is we think that primary creativity, that one is born with this capacity. Now later on, and I think this is important to know, Kahn says that Winnicott worked with 3 percent. He could work with the 3 percent in the individual. So in some sense, that's what we're looking for when we look at the patient and try to figure out, if you will, the quotient of aliveness or deadness.

Khan and Winnicott were quite an odd couple. The only reason Winnicott's concept of primary creativity comes up in this context is the fact that it creatively emerges in what might be termed the context of a “creative”, “destructive”, “mad enactment” [i.e. Winnicott’s relationship with Khan]. As Ferenczi said, “You have to catch your hare before you cook it.” The hare may have been wild game periodically treated by “local spoiling”. This is the beginning of their analytic career, their editorial career. So out of that creative couple, the id and the odd, if you will, comes this theory of primary creativity.

The second point that I want to talk a little bit about is creativity and I'm not touching any of the major ideas, but I'm going to try just a few of them. I'll read some of this, some of it will make sense. “With a splash of paint” -- that's from Winnicott, but “With a splash of paint and a smack of Hamlet ,” Coleridge said, “I've got a smack of Hamlet.” Winnicott was interested in madness his whole life. It is the thing that really connects. It is the glue of his theory. If you go from absolute dependence to radical non-compliance in the false self.

So he's got three things that he's working with, and I'll give you three images. One is the splash of paint. The other is a smack of Hamlet and the third is the smell of hyacinth. He looked at the hyacinth bulb and he said we murder to dissect. He looked inside of it and he couldn't find the origin of the scent. The smell of madness. You have the smell of madness, but you don't know exactly what the originary experience is. What the original breakdown, the original madness “X” is. You have a sense of the defenses, but you never get anywhere but next door to it. It's ever present, waxing and waning.[29] At least that's what I feel in reading him. Some people think not.

Winnicott “entered the game” to use the “unread” Ferenczi's phrase (I always see a connection between these two guys, certainly intergenerationally. I think everybody sees that). The “game” was psychoanalysis conceived of as a creative process. If only for 2 or 3 percent of it was creative. The goal was a sort of Everyman theory of creativity. That is, he felt every man had it. The view that creativity is psychically innate, ultimately everybody is the creator of the world, if only just creating the breast over and over again. He says the retention of that feeling that is conveyed in that space with the mother, that you've created the breast, that you can create the world. Hopefully that stays with you your whole life. It's an imaginative act to retain it throughout life. He was very interested in that imaginative act which he called creative apperception. I'm just going to read you some quotes rather than reading my text. “Creativity is then the doing that arises out of being. It indicates that he who is, is alive.”[30] When one's creative, one is most alive and most real, most true. And it is informed by the spontaneous gesture. He said, “Impulse may be at rest, but when the word ‘doing' becomes appropriate, then already there is creativity. Creativity is then the retention of something that belongs properly to the infant experience and the ability to create the world.” [31] And hopefully we hold on to that our whole lives. At least he thought it was a possibility. And it was a possibility for him.

I'm just going to make a few more remarks about creativity. There are a variety of articles where he talks about creativity. One that's most interesting that he wrote sort of towards the end of his life was Living Creatively.[32] I think he was thinking about it very seriously for a larger population. He said that creativity is what makes life worth living. It arises out of our being. It's the doing that arises out of being. Creativity is a tension between “a predominance of impulse-doing over reacting-doing”, so here you get the issue of the true and the false self . It's a retention of the infant's belief that he created the world. “The Reality Principal is the fact of the existence of the world, whether the baby creates it or not.”[33]

He talks about the Reality Principal as being an “insult”. And this insult has to be negotiated by the mother. It's just too bad, he says, that there's such a thing as the Reality Principal.[34] For him, the Reality Principal or destructiveness makes everything external. So all of this is based really on the use of the object. The concept of the use of the object is an integral part of destructiveness and an integral part of creativity . That's why I said a few minutes ago that these papers and these ideas are still subjective objects for me. I haven't quite been able to play with them as much as I would like to play with them.

I'm going to go to the second piece. You have a sense of what he means by creativity and certainly intermediate space, creative apperception, transformational object. He talks a little bit about formal artists. He said they have more formal training. He feels that there is perhaps more ruthlessness in the formal training. But he's really interested in the creativity of everyday life rather than formal artists. He does talk about artists in certain places. Somehow in writing this there were two ideas that came to me and they are free associations. One is, I felt as if in reading him, he's very difficult to read. Grolnick uses an image. He says he has a colleague who is a Dickinson scholar - that is, Emily Dickinson. Every time she gets time off from teaching to go back to her scholarly work, she has to re-read all 1,500 poems. That's why every time you go back [to read Winnicott], you have to re-read the whole thing because you're pulled into this gut hermeneutic circle and you have to live the article and it's a nightmare. You want to go in there for an easy definition of play, you know. So you get a sense of what it is. I had a sense of reading Wordsworth on LSD after a while (group laughter) because it was just swimming in my mind.

Let me talk about destructiveness for a minute .I think of Winnicott as a hallucinator. He's an hallucinogenic thinker. We have all these transitional spaces. We have all these images. He said -- and I think this was his issue with the British society -- that people who are hallucinators, people who think in pictures, which I think he counted himself as one, he said sanity does not belong to them. Sanity only belongs to the word people. I think that was directed at many of his colleagues. Freud said analysis is analysis of the text. For Winnicott, I think that the reason we have so many spatial concepts with him is because he was so visual and he was an hallucinogenic thinker. A friend of Charles Rycroft once referred to Winnicott as the most aggressive man in London.[35] I loved that. The irony and the paradoxicality of that appellation is not lost on those who read his work.

I am, however, going to give short shrift for the sake of time to the topic of destructiveness in this trilectic of creativity, destructiveness and madness. “What is more important”, he wrote, “is to reach to the basic forces of individual living, and to me it is certain that if the real basis is creativeness the very next thing is destruction.” [36]Self-consciously, his whole life, he was always reaching for a kind of aggression, an articulation of his own hatred, a certain kind of force. Because it was so self-conscious, I think it was an issue. I think people have attacked his therapy because they felt he wasn't as confrontational as perhaps he should be. The necessary enlivening, life-enhancing dimensions of destructiveness in this “”all-too-nice grown-up not eight or nine year old”, accused of possessing an “excessive benignity” and “exalted sincerity”, were being reached and reflected upon his whole life. He was ever locating his hate. I can give you an example, certainly, in Margaret Little, who attacked him, attacked his vase, but he writes a letter about how he had to hold her hands -- and again it's touching; Masud Kahn touched his chest, he's touching, Margaret. He's holding her hands for hours at a time. And he says it's like keeping her in a padded cell. Because very much like Ferenczi, he says, “I put myself in the hands of a not undangerous patient.” Otherwise, she would hit him. And she did. So that's why they arrived at this piece of it. That's in his letter. I think it's in her account by implication.

Emerson once commented on the English utilitarianism. “They love the lever, the screw, the pulley,” etc., etc., “and the wind to bear their freight ships.” Destructiveness is the lever, the screw, the pulley that bears much weight, I think, in Winnicott's ideas. And certainly, it's something to think about in the history of heroics that we have.

I want to mention a letter that he wrote, which is fascinating to me. And it's in Rodman[37], because it gives you a sense of the destructiveness. He had a patient who committed suicide at Cassel Hospital around 1950. Winnicott had a heart attack. He couldn't write about this patient for seven years. He had given her Seconal that she used violently. “The characteristic of this kind of patient,” he writes,” is that hope forces them to bang on the door of all therapies which might give the answer. They cannot rest from this and, as you know so well, their technique for mobilizing activity is terrific in its efficiency. In this particular grouping I think there's a dynamic force which might destroy psycho-analysis. ... Psycho-analysis cannot ignore this group any longer but must know that it provides a threat. The psycho-analyst’s life is likely to be threatened by one or two of these patients... these patients make us try hard because they have hope and because it is hope that makes them so clever; yet at the same time the fact that we cannot provide what is needed produces a disaster... These patients need a very complex situation in which they can regress ... [which will] neutralise the destructive potential of this group... Indeed I would say that the more psycho-analysts are able to do this kind of work with a few patients the more patients there are who will begin to have hope and therefore will begin to bash around in a ruthless search for the life that feels real.” He was terrified and goes on and says,“...if psycho-analysts ignore [this] they could destroy psycho-analysis...” [38] So he was very aware of it. I think often, humorously, of a remark that was made by a very well known Freudian. He whispered it, and what he said was that the British treat mad patients and they meet them more than halfway. (group laughter)

I think that sort of brings us to my third idea and that is this trilectic .I borrowed that idea of a trilectic from Eric Rayner who was trying to figure out how you describe the three groups in the British Society. He talks about them as a trilectic and it was the first time I’d ever seen that kind of phrase and I thought it was marvelous. Let me just give you some of Winnicott’s ideas about madness. They’re contained in two major articles, The Fear of Breakdown,[39] which you've all read and then he begins to revise it a little bit laterin The Psychology of Madness.[40] I'm just going to give you some of the ideas that come up and I think Elsa brought up some of them previously.

We seek our madness in order to be normal. So that tension is always there. We never quite reach it. We never quite reach our madness. We might get next door to it. We are “forever caught up in a conflict...between the fear of madness and the need to be mad”[41] The need to be mad and the fear of madness. It's a marvelous tension that he talks about. The breakdown happened before you were able to experience it. What you do experience is a terror of the reorganization of the defenses in terms of what he's talking about.

What I would like to do is go to some of the clinical examples that I have. They're actually from Winnicott. The first is a review he did of Jung's book, Memories, Dreams and Reflections.[42]He considered Jung -- and I’m increasingly aware of this -- a Doppelganger twin and he identified greatly with him, except that he didn't have a schizophrenic break. There are certain differences in their backgrounds. He says, I'm not running Jung down by labeling him a “recovered case of infantile psychosis. ... If I want to say that Jung was mad and that he recovered, I am doing nothing worse than I would do in saying of myself that I was sane and that through analysis and self-analysis I achieved some measure of insanity.”[43] He was always in touch with usable madness. His own usable madness. He goes on and he analyzes Jung and the divided self and he says that the Jungians have never recovered from Jung's divided self nor have the Freudians ever recovered from Freud's flight into health.(group laughter)

He has a phenomenal dream. He has a series of dreams when he's reviewing that are extraordinary. These are in a letter to Michael Fordham, [a Jungian analyst and friend] found in Psycho-Analytic Explorations[44]in which he says the dream encapsulates a trilectic of madness and destructiveness and creativity. He writes the dream had a special importance which “...cleared up the mystery of the element of my psychology that analysis could not reach, namely, the feeling that I would be all right if someone would split my head open, (front to back)and take out something( tumour, abcess, sinus, suppuration)that exists and makes itself felt right in the centre behind the root of the nose.” The dream was in three parts. “There was absolute destruction and I was part of the world and of all the people and therefore, I was being destroyed. (The important thing in the early stages was the way in which the dream was pure destruction got free from all mollification such as object relating, cruelty, sensuality, sadomasochism, etc.) 2. Then there was absolute destruction and I was the destructive agent. Here then was a problem for the ego, how to integrate these two aspects of destruction? 3.Part three now appeared in the dream. I awakened. As I awakened I knew that I had dreamed them both (1) and (2). I had, therefore, solved the problem, by using the difference between the waking and sleeping states. Here was I awake, in the dream, and I knew that I had dreamed of being destroyed and of being the destroying agent. There was no dissociation.” I remember, he felt he was the undissociated successor of Jung and thereby, I think, being the successor of Freud. We remember ,after the dissolution of the relation with Jung, Freud said something to the effect, ‘No more towheads in psychoanalysis.’ No more disassociation was an important piece for him.

SHEILA RONSEN: Thank you Judith. We will now hear from Murray.

PRESENTATION BY DR. MURRAY SCHWARTZ

I come to Winnicott primarily from Literary Studies. But also because the influence of Winnicott among, at least some students of literature, extended to bridges between clinical and pedagogical psychoanalysis. So I want, in part, to say some historical things about Winnicott's place over several decades; but also to talk about what seemed important and attractive about his work as early as the late '60s.

In Literary Studies, psychoanalysis was, in the '60s, primarily quite an aggressive tool. It was a way to challenge the complacencies and pieties of a lot of Literary Studies and literary theories. It was initially quite seriously resisted. When I was in Berkeley in the '60s, things might have been breaking open in a lot of ways, but people resigned from my Ph.D. committee because I had a book by Erikson on the reading list. So Winnicott seemed to promise, at that time, a kind of kinder, gentler psychoanalysis. A way of moving beyond the aggressive suspicion of Freudian-applied psychoanalysis into a world where there would be more trust, more flexibility, more openness and less ideological insistence. So he seemed to promise a kind of squiggle relationship. He could squiggle, we could squiggle. We loved that kind of ruthlessly idiosyncratic style of writing and being psychoanalytic. At least in Buffalo in the late 1960s, where an extraordinary number of people assembled who were interested in theoretical and applied psychoanalysis across a very wide range of disciplines.

We also were taken by a speaking voice that we found in Winnicott. The way in which he speaks as an equal, neither patronizing nor apologizing, but with a kind of signature elusive openness that seems all out front but masks strong claims to an original place. I mean that in two senses. He's claiming the place of the mother and child, claiming what came to be called the pre-Oedipal domain of psychoanalysis. But also claiming his own originality, his own place. He was for us and I still think he is what Harold Bloom would call a “strong poet” of psychoanalysis. That is to say, deliberately reading his rivals and precursors in a way that opens up a new space for himself. And so we loved his love of playing, of paradox, of profound yet simple observations, his lack of what Adam Phillips called “the dreary earnestness or mystifying jargon that mars psychoanalytic writing after Freud and Ferenczi.”

I also love his interest in the etymology of key words. Winnicott is very sensitive to etymologies. He has a sense of the history of the words he uses; how they connect with individual and collective meanings. So as a writer, as a public speaker, he invites dialogue not discipleship. He is not asking us to accept a particular set of theories or concepts, but a way of being psychoanalytic; not engagement just with him, and not submission. A kind of mutuality as opposed to hierarchy.

All this connected with some of the deep ambitions of the '60s. A British democratic sensibility. You can see this in some of the literature of the period , the literature that grew up in Europe and America shortly afterward. The kind of playfulness you find in, say, Milan Kundera, who I have been teaching recently and who, if I had time, I would quote to show how similar he is in some ways to Winnicott. But he also was extremely useful because we could see in literature ways in which Winnicott's concepts were illustrated by the failure of mutuality, play, potential space. Recently, I've also been teaching Elfriede Jelinek's books, The Piano Teacher and other books that are about worlds in which potential space doesn't exist. And mother-daughter relationships in which violence and absolute impingement controls a kind of masochistic, pornographic universe. Winnicott helps open up all of these possibilities for understanding varieties of literature.

I can also see in Winnicott, and have, actually, written about the way in which he gives us a means to conceptualize the ways genres work in literary study as well. For example, you can imagine tragedy as about, in general, the collapse of potential spaces. Winnicott was very interested in Hamlet. Hamlet is trying but desperately failing to negotiate a potential space for himself. He's very violent in this effort. He's the most violent character in the play. But finally, he has to admit that he isn't writing the script. When he comes back from the sea he says:

Being thus be-netted round with villainies,-
Ere I could make a prologue to my brains,
They had begun the play- (Act V, Sc II)

So the struggle becomes who's script is it and the revenge cycle always involves that kind of struggle. Who is going to write the script of this play? Who is going to authorize this play? We can also see that collapse in other and I think even deeper ways. For example, Lady Macbeth gives us a kind of paradigm of the collapse of cultural space when she incites Macbeth to the murder saying, just before he agrees:

...I have given suck,and know
How tender ‘tis to love the babe that milks me:
I would, while it was smiling in my face,
Have pluck’d my nipple from his boneless gums,
And dash'd the brains out, had I so sworn as you
Have done to this.(Act 1,Sc VII)

To which he replies,

If we should fail?

-the first time in the play he uses the word ”we,” as if that terrifying possibility leads him to merge with her and become her instrument–“while it was smiling in my face,”-at the moment of communion. So Winnicott was very aware of these sorts of moments, simple observations all through his work.

And you find it in his language. Words like the “perpetual task” of keeping inner and outer separate yet interrelated. Perpetual task. Not an achievement, but a life-long effort. Or a space that's “sacred” to the individual. There aren't many psychoanalysts that use the word ”sacred” that way. But he meant it, I think, very seriously.

On the other hand, we can find lots of examples of what he called potential space in comic forms. And I think you can understand comedy as a way in which characters successfully negotiate creating the world they have to live in. Twelfth Night is my favorite example because all the characters in that play are literally moving up and back between two houses and trying to negotiate their place in the world and they succeed. All except one, who is filled with persecutory anxieties ,as Winnicott would say, Malvolio who vows revenge on the whole pack of you. So there was a play which is right on the edge of the tragic possibility which threatens to overwhelm the comic atmosphere. But, in fact, it's a play about good- enough living. Almost everyone finds something good - enough. A match that fits. I think Winnicott's vocabulary becomes a very, very rich and useful way of conceptualizing many, many aspects of the literary studies. And that's partly because he was aware of these things. I mean Hamlet is quite present in Winnicott. But so, as you (addresses JK) just pointed out, is Wordsworth and other Romantics. In fact, you can find direct precursors of the notion of cultural space in some of their poetry. Wordsworth, for example, describes the way in which, The child “...trailing clouds of glory” finds his way “into the light of common day.”[45] That's to say, what was a private symbolism becomes the world of cultural objects. These are direct antecedents, precursors of Winnicott's way of thinking.

I also love the way in which he uses the phrase, “belongs to.” This belongs to that. How wonderfully ambiguous. How does it belong? This goes with that. But there's a built-in flexibility that draws you in to imagine things that aren't stated. And he does that over and over again. I picked one example almost at random, the 1962 paper called “The Aims of Psycho-Analytical Treatment” .[46]It starts, “In doing psychoanalysis, I aim at: Keeping alive. Keeping well. Keeping awake.” And then he goes on to say well these things are really quite surface matters. But are they? They are pretty fundamental things, aren't they? That's the way he could create a kind of seductive space in which we begin to work with him in imagining possibilities in the most ordinary kinds of phrases.

In the short time available to me, I just want to point to two other things. One is, this led to forms of teaching psychoanalysis, which we came to call Delphi seminars after the oracle at Delphi which said, ”Know thyself.” And this was a way of teaching in which both the teachers and the students would write in the most free associative way they could about whatever we were studying, a poem, a play, a movie and then share the free associations. This would go on for a number of weeks and then we would do what we call the Delphi turn. We would begin to write about each other's associations. We would have a package of responses. The aim being for us to discover and help other people discover what they brought to the literary transaction. What it is that we were investing the things we read with and were wanting to criticize with. How we brought ourselves to everything. So that instead of making subjectivity the enemy of Literary Studies, it became a vehicle for understanding both one's self and the object. A completely interactive mode of teaching which I think was very much derived from Winnicott.

I want to point out some more recent uses of Winnicott. Winnicott, for me and I think for quite a few other literary people, has become valuable in Trauma Studies, especially Holocaust studies. Because he conceptualized what I call the “Z” experience in The Location of Cultural Experience[47] where he talked about “x plus y plus z” separation. “Z” separation leading to what he calls a break in the continuity of being. The “Z” experience is everywhere in Holocaust literature. And the struggle to respond to having undergone the “Z” experience is there also. You used the word “anguish” at one point, Elsa. That's a very common word in Holocaust accounts. I think it indicates the limit of one's capacity to mourn or integrate that experience. It comes back as anguish. So Winnicott continues to be extremely useful in more contemporary interests because this interest has now spilled over into Trauma Studies in a much broader sense than just Holocaust accounts.

Finally, I want to raise a question about Winnicott. Because in his celebration of cultural spaces and play spaces for individuals and for societies that have thriving cultures, he probably wasn't thinking of contemporary Western cultures or American cultures in the sense that they have become suffused with illusory and seductive images. When the world becomes full of what the critic Baudrillard, who died just a couple weeks ago, called “simulacra”. When we're living in a society that seems to be consuming everything it can, what is the fate of these spaces? Is there a limit to potential space? When you talk about transitional objects, you're talking about something that, by definition, has to have a limit. A transition has a beginning and an end. What's the limit? Or to put this perhaps in another way that might be a bit enigmatic, but people have pointed to it, where's the father in Winnicott? Is there an implicit father in Winnicott? Is there some way that we can read Winnicott to find an adequate theoretical language for this implicit father? That's a question I guess that's on my mind these days.

SHEILA RONSEN: We will now open up the space for Fayek and Elsa to respond to Judith’s and Murray’s presentations .

RESPONSES OF FAYEK NAKHLA AND ELSA FIRST TO THE PRESENTATIONS OF

JUDITH KUSPIT AND MURRAY SCHWARTZ

FAYEK NAKHLA: I have something to say about Winnicott and madness and also, a response to Murray’s question , Where is the father in Winnicott? Winnicott was always living on the edge of the no mother experience. He was in the state of the infant and the no mother experience, which is a state of madness or what he described as the primitive agonies of annihilation. He gave a whole list: Falling forever, going to pieces. Winnicott reconstructed this mother, what goes on in the infant and the mother, not by observing infants or working with children or infants. He arrived at that from working with psychotic patients, from what he called his research analyses. He mentioned that he worked with these research analyses, but unfortunately he gave very little clinical material to illustrate what he did. What he did we got from people like Margaret Little who described what he did -- but he said nothing except in his 1954 paper on regression.[48] The only statement he could make was it took everything out of me as a pediatrician, as a psychoanalyst, as a human being. So there's something very engrossing and disturbing in that work. Winnicott always wanted to be close to that edge of insanity.

In addition to working with psychotics in his research analyses, he also, as you probably know, did have in his home some psychotic patients. I don't know how many psychotics he had, maybe one at a time. The well known case, if you're familiar with Marion Milner's book, TheHands of the Living God. This was a schizophrenic psychotic patient who was living in Winnicott's home. In fact, he was so invested in her, he arranged for her analysis with Marion Milner, he even paid for the analysis. And so he was continuously in touch with that edge of psychosis. His remark, “We are poor, indeed, if we are only sane.” This is what Winnicott was trying to complete continuously in him. So he was always on the edge of that and connected to it continuously. He said in both of his analyses-- he was in analysis with Strachey for ten years and then with Joan Riviere for I don't know how long, but he did say that in both analyses there was something that was not met by his analysts. There was something he could not reach. And he did say that the areas of work that we choose or whom we select to work with is our attempt, through working in these areas, to complete or to reach what we could not with our own analysts. And this was his work with psychotics; that’s how he developed all the maternal functions because he could see that in his psychotics. He reconstructed the infant model from his work with psychotics who gave him a clear picture of that failure [of maternal functions ].

I think this is also what's described about creative artists who had experienced a major deficit in terms of their maternal environment. Somehow they use their art, whatever medium it is, to create what was missing in the mother. I don't know if you (addresses JK) agree with that, but that medium becomes the creation of the mother that was not there.

I had a patient -- am I going on too long?

SHEILA RONSEN: No. Keep going. This is not incontinence. (group laughter) FAYEK NAKHLA: This patient of mine was very accomplished, very prominent. I'm not going to say what field he's in. But he was really omnipotent in everything he did. I found myself continuously having to hold back my envy. He could do anything. In all fields. Not only his field. In constructing part of his house, he would do it himself. He was a genius. And he was omnipotent, you know. Really. (group laughter) But he was always exhausted. Whenever I’d pick him up in the waiting room, I could hear his sigh. The other thing is when he would go to bed at night, he could never sort of undress. He would stay in his suit or whatever he was wearing. He could not let go of the structure that he had formed. He was telling me when one of his art creations was put into a very prominent museum, somebody told him, “You must be happy, proud”. He says “You know what this feels like? That I've been walking”and he's in his mid 50s“barefoot all my life. And at this point you give me a pair of shoes.” But that feeling, “walking barefoot all his life”. So Winnicott could never even get to the point of a father. He was on the edge of this no mother-infant continuously.

JUDITH KUSPIT: Just a few odd things. I was just thinking about your artist patient -- and certainly, the exhaustion disease sounds like the Guntrip situation where you have no sense of going–on - being. I think [Auguste] Renoir said that they give you beefsteak when you have no teeth, in reference to your patient who was walking in his bare feet.

JUDITH KUSPIT: Because of very complicated relations. One, he was probably half in love with her; two, he analyzed her husband; three, there was a supervisory situation going on; four, she had the sensibility and was closest to him as British. She also was a hallucinogenic thinker and a brilliant woman. It's interesting, because in relation to the father or thereabouts-- she goes and consults with Clifford Scott about the end of her analysis with Winnicott. Scott says, with Winnicott, it's a travesty. He says, what you want is that genital thing. Go after it. So it's that genital thing; and the father and sort of the Continental cod piece college of Europe versus this cult of the nursery in psychoanalysis. I think that some of these people got caught in that situation.

MURRAY SCHWARTZ: I have a suspicion that somewhere in Winnicott's mind, more than he admits, is Lacan. He makes a reference to him in the mirror role of the mother and family.[49] His answer to Lacan, in effect. He says I've read Lacan and learned from him, but here's the real story. So when you (addresses JK) said continental, I think it’s there. Maybe he's responding to what's going on not just in London but in Paris, also.

JUDITH KUSPIT: I don't know, but I'll tell you that, in terms of the transmission of intellectual culture, it was through Masud Kahn. Kahn spoke excellent French and even the French were trying to perfect it. The French were the only ones who would publish him after the scandal, the only ones who received him. It was Kahn who took Winnicott to the Continent. The British often -- and we feel it here -- they don't import. They have mal-de-mer. They get seasick. So they don't cite us, we cite them like crazy. The French cite Winnicott. But yes, he does make that reference to Lacan and I'm not sophisticated enough. I've read Lacan for years and I don't think I could answer any relation between the two of them.

FAYEK NAKHLA: But doesn't that fit with Winnicott's not acknowledging anybody else's ideas, thoughts? And that's where Winnicott is the ruthless guilt-free artist. He says that in a couple of places. Even early on, in his 1945 paper,[50] he says, I pick up this idea and that idea and whatever I hear and then I bring it back to clinical material. And the last thing I consider is what I've stolen from whom. That got him into trouble, too, , the non-acknowledgment or the not citing.

JUDITH KUSPIT: It's a nightmare. It was a nightmare for people who felt that their ideas were being bootlegged by him. The anxiety of influence and that original symptom he had when he went in to see Strachey . I think it was a glottal symptom where he didn't know the difference between internal and external. So if you spoke with him, his throat would move. He said he also listened with his throat, it would move. It was very difficult because his throat would move in terms of your words. I used to think ,when I first read him, God, this guy has [Harold] Bloom's “anxiety of influence”. It's like artists that won't go to museums but it's much more severe than that. And people resented it immensely. But that's how his creativity was so under threat. He wouldn't read Ferenczi. Ferenczi was unread because he had a sense of what was in Ferenczi. But Masud Kahn read him and he had a Ferenczi patient on his couch. But he deliberately says, I will not read this man. I will figure it out for myself. So it's a real issue that he had.

FAYEK NAKHLA: In terms of the external reality or Winnicott’s back and forth connection to it, others have described that even when Winnicott would be crossing the street, he wouldn't look for the traffic. He would just walk.

ELSA FIRST: Well, I guess what it links up with for me is the question of stubbornness.

FAYEK NAKHLA: Yeah.

ELSA FIRST: Stubbornness versus negotiation. Obviously, there's a stubbornness in Winnicott that is necessary or creative. Anyway, as you say, we feel the ruthless stubbornness. There's something good about it. And yet there's something limited about it. I feel like I’m in the human realm here and I’m not getting nearer to the hell realms.

A question that came up for me was about the destructiveness, about his relation to destructiveness, and the destructiveness in that last dream that's in the posthumous work. Winnicott spoke of the back cloth [of destructiveness] and the use of the object. The relationship between destructiveness and the appreciation of otherness, which he was wonderful on. It's a very rich theme in his thought and I would think that's been much brought out today. Survival of the object being what makes the object real and external and it's no use being only stubborn. So I'm a little puzzled what his experience was in that dream about the destructiveness, which is everything destructiveness, impersonal. Then there's one where he's being personally destroyed and then there's a third one in which he may be in more of a depressive position destructiveness. I remember reading that many times thinking what did he really get from that dream and what did he think he was working with? So hatred is a kind of human realm, not a hell realm. A human realm aspect of Winnicott that I feel at home with like in Hate in the Countertransference.[51] Hatred at being used, not used in a good sense. To notice [in contrast]that moment in analysis where the analyst becomes really usable, I mean, what a beacon of something to look for, really. One of those astonishing markers or milestones, like the capacity to be alone that Winnicott was so good at putting his finger on. So his hatred at being used as -- well, used, even used up is something he was very in touch with. At the end of Piggle, actually, he says, at the end of the hour, he says to Piggle, so glad, you know, you're done with me and I don't have to be the special treatment Winnicott invented by you. He could go back to being “all the other Winnicotts.”[52]

So I'm back to the role of negotiation . Negotiation, I don't agree, is entirely the false self. In fact, that's what maybe you (addresses MS) were trying to say. You can only negotiate if you understand that others have subjectivities with different points of view. We now-a-days [have the concept of] theory of mind . Through playing [the child comes]to understand mutuality, similarity and the possibility of alternate, although exchangeable perspectives. We would like to see more negotiation in the world, right? Less stubbornness at this point.

So this brought me, also, to the question about the collapse of cultural space and commodification and how this links with, if I dare say so, bad stubbornness.

MURRAY SCHWARTZ: Right on. I mean what can I say? I think, though, there may be another facet to this. It's not just bad stubbornness, but a kind of denial of the inner life. In trying to think about contemporary issues, it sends me back to the 1935 paper on the manic defense,[53] which I think is kind of uncannily relevant to the contemporary scene. But it's not just stubbornness, it's a culture of the denial of the inner life. That is to say, if you feel uncomfortable, if you feel anxious, if you feel troubled, you want to get rid of the feeling. You want to take a pill or categorize it somehow so that it can become encapsulated as a treatable thing you have. You don't experience things. You have them. You have depression. Or you have attention deficit or you have all the DSM categories. So the culture begins to think that it can manage everything without even naming it an inner life, by externalizing it and somehow materializing it. That seems to be another dimension of the loss of potential space. And it's an insidious one, because it can go unrecognized in the enormous celebration of the cures that we get surrounded with.

AUDIENCE PARTICIPANT #1: (addressing MS) What’s the answer? How do we fix it?

FAYEK NAKHLA: This manic thing is also close to the compulsion that the creative artist has to continuously create. They can't just indicate and say okay. I think, rather than stubbornness, the word I think that also applies to Winnicott very much is non-compliance. He couldn't stand compliance. In fact, Newman's book is titled Non-Compliance in Winnicott's Words.[54]

ELSA FIRST: Judith, can you tell me about destructiveness?

JUDITH KUSPIT: For Winnicott, destructiveness is the back cloth of every experience. It’s also transformative and, as far as I can see, a part of the imagination. While I was writing this stuff I was thinking about something -- you (addresses FN) mentioned the artist -- I was thinking about Duchamp and I once had somebody say to me, “Well, anything I do is psychoanalysis.” I said, “Well, it sounds Duchampian to me. Like Duchampian analysis.” But I was thinking about Duchamp's urinal because some Japanese just urinated in it the last couple years. Duchamp gets a found object, he puts it in a museum -- here's the collapse of cultural space. You don't know exactly what the transformation is or where the imaginative piece or what the creative apperception or where the negation of the destruction is. And he calls it art. There's a missing transformation. And then if you really want to get super-subtle, you call it the anti-art. So you start that cycle, again, if you will. But that seems to me to be an objective correlative to the collapse of that kind of space. Even in psychoanalysis, Winnicott says, in his response to Freud, I'm not going to work from his score. He's not interested in any kind of score. And I think that Elsa's idea of non-technique technique dimensions [in Winnicott] is a very important idea. I'm not exactly sure what I can say about destructiveness except that I think it was right -- like the devil was at his right hand. I think it’s a little bit like somebody who went to William Blake's house and asked where William was and his wife said, haven't seen him, he's so much in Paradise. And I think Winnicott's Paradise has a lot of destructiveness. There are devils in that paradise ; that dream, I think that he had; and the identification with Jung. Absolutely powerful. It's almost a visceral identification with Jung.

MURRAY SCHWARTZ: I think I'm struggling with your(addresses AP #1) question, what do we do about this, because we can't just leave it at a kind of diagnostic pessimism. I mean, we wouldn't be here if that's all we thought were possible. But it seems to me part of the response is to try to make a link -- and here, Winnicott, I think, can be enormously valuable -- between contemporary anxieties and cultural phenomena, and the psychotic anxieties to which they are responding. Here's my sort of thumbnail sketch of a personal theory: It seems to me that in the middle of the 20th century and with preparation that goes back to the early part of the century, certain psychotic anxieties entered our culture that we're struggling with all the time. They’re evoked obliquely and sometimes directly every day. The mushroom cloud. The weapons of mass destruction. Endless war. Spaces in which we lose all social identity. These sorts of things, playing around the edges of consciousness. Becoming aware of how they're a part of living in the culture is a step in the right direction, it seems to me. Because they’re on everyone's mind. And we see them flickering on and off the media all the time. And they can be enormously useful to people who want to exploit them, as we see.

ROUNDTABLE PARTICIPANTS OFFER FURTHER THOUGHTS ON ASPECTS OF WINNICOTT AND HIS WORK

SHEILA RONSEN: I want to ask all of you if there's something you really are dying to say that you haven't said or haven't had an opportunity to say. This is your moment. Then I’ll open it up to the audience for questions and comments. Any last words on anything you wish to say?

FAYEK NAKHLA: Yeah. When you cut me off,(group laughter) there was --

SHEILA RONSEN: Okay, bring it on Fayek.(uproarious laughter)

FAYEK NAKHLA: I'm just going to talk about what it is and that's Winnicott's paper, Mind and its Relation to the Psyche-Soma[55] and where there's a double abnormality: there's the false self, and the precocious, excessive use of the intellect, the mind. That combination is deadly in that the person is not connected to any real self, but is working out all of his personal problems with excessive intellectual activity of the mind. Winnicott does say that the mind is important very early on in compensating for minor maternal non-adaptation, you know the infant can think and so on. But if it's exploited, and you especially see that with very highly intellectual people, who are academically successful; and you underestimate or it’s deceptive to see the lack of their distress or emotional cut off.

JUDITH KUSPIT: Perhaps just three things. One is, Winnicott continually repeated his idea that we're poor, indeed, if we are only sane. That was with him for his whole life from the beginning of his career, and in at least three places in print . The mere destructiveness is what he's trying to deal with, I think, in that paradox.

I've tried to figure out what paradox is for him and you (addresses MS) raised the issue of how much space is a potential space. That somehow the paradox, any paradox, like the capacity to be alone in the presence of another person, any paradox seems to frame the space for him. Somehow it's a frame. The problem is that you can go in infinite directions either way but the point is that, he does imply that there's a frame. He always wants a frame, a holding in any situation, so you can use any technique you want as long as he's got a holding, as long as it's regular ,the illusion of reliabilities, etc. So there's something about the paradox that frames these spaces that he's hallucinogenically whipping up.

And this is the third thing. I didn't read you some of the [written]interaction of an analysis [by Winnicott]that we know is Kahn and it has to do with the artist and gender issues where Winnicott said, “the madness is mine ”, because he sees a girl on the couch and it's Kahn. And then he said something like, You can see that it's taken me a great deal of work to come to that realization. Of his own madness . So my feeling is that Kahn is sort of madness “X”, if you will. That's in The Psychology of Madness[56] in flagrante delicto in terms of the psychoanalytic world.

SHEILA RONSEN: Murray and Elsa- Is there anything more you’d like to say? (they shake their heads “no”) So now I’d like to open up the conversation and invite the audience to share their questions or comments.

AUDIENCE QUESTIONS,COMMENTS AND ROUNDTABLE PARTICIPANTS’ RESPONSES

AUDIENCE PARTICIPANT #2: I was interested in the social context you (addresses MS) were talking about, the lack of potential space and the absence of the father figure. And what I was playing with was the idea of the absence of non-dissociated, male leadership in the society–of course, I'm particularly thinking about our country -- as creating that lack of potential space.

MURRAY SCHWARTZ: Well, that certainly seems to be an accurate reflection of the current condition that we're dealing with. But I think, aside from the direct political implication, it leads me to think about the dilemma that I find a lot of male students struggling with these days . They can't figure out how to be men. They don't find a model that seems to work, which is not to say they don't admire their fathers. They just can't find a model that they feel could carry them into the future. So I think it's a broader issue about the role of fatherhood, maleness in our society. And ironically it's partly a response to the success of two waves of feminism. Which is not to say it was caused by that at all, but it certainly left an ironic problem in the culture for young men who are trying to find an adult identity. I don't think this is by any means confined to America. There are male cohorts, adolescent male cohorts, all over the world struggling with this problem. Especially where there are severe economic deprivations and they can't see the possibility of living either a traditional life or some other one. I think that this is a potentially very explosive dimension of the global situation. I say this because an experience I had in Africa a couple summers ago in which when you visit villages, all the children gather around immediately but in every village the young men would come up to me and ask if I could help them get connected with a job, with leaving the country, going to America, finding some other life because they saw no possibility for them in their own societies. And they're under very severe surveillance by the political powers.

AUDIENCE PARTICIPANT #3: I wonder if anyone could say anything about Claire Britton who, from my reading and teaching of Winnicott, was really responsible for making the Winnicott that we know. She helped him separate from the domination of Melanie Klein and actually, in the second marriage, kind of demanded in her letters to him that he become a man. He had his first sexual experience with her during the affair that they had during the War when he

was 48. So I wonder if anyone can say anything about that personal side of Winnicott, that perhaps Winnicott, himself, also struggled with his own manhood.

JUDITH KUSPIT: Yes. It was manhood, but–[Claire Winnicott] took all the letters to his first wife and burned them. But it may be that -- I'm just using this metaphorically, -- his first wife or companion may have been Kahn. They [Clare Winnicott and Masud Kahn] hated each other. Kahn said that relating to her was like relating to a scream. If you remember, Winnicott said the scream was the first response to panic. He didn't say he was screaming, he said it was like relating to a scream. They disliked each other. And she was the one that may have been responsible for not letting Kahn edit. So it's not clear. Winnicott created Winnicott. But he was able to get very intelligent people around him in Claire Winnicott. I think an argument they had relates to the antisocial personality. I think he felt that there was a lot of hope in it. She felt that sometimes the delinquent goes too far and cannot be held and there may not be that transformation of hope. He may not feel the hope in his bones. Just like that letter in which he says there may be patients who kill us and kill the field.[57] She was willing to go farther and say yes, there are, there may not be that transformative hope. So, in that sense, he hit steel in the letters.

The little bit of the letters that I've read, it's very poignant reading. Be a man, she wrote to him. I think it's fascinating. But there's nothing unkind in it. It's I don't want to take on this role. Either you take it on or it's not taken on. And he, for the first time, organizes his aggression. He always said you have to have aggression for sexuality. He even wonders in his paper on creativity how do people make good marriages when all I hear is there's bad sex. Of course, he didn't have sex until he was in his 50s which was probably problematic.(group laughter) Going back to the male, he went, deliberately, I think to Strachey and he went to Bloomsbury for his first analysis. Strachey was certainly married to a very powerful woman. But he had no genital interest in women. So we have this phallus, the absence or presence may have been missing in that sense. I'm just trying to use language to try to talk about this. But it does come up in his treatment of Kahn, just as they both wrestled with male-femaleness.

FAYEK NAKHLA: Judith, is this correct that Winnicott could only divorce his first wife after his father died?

JUDITH KUSPIT: Yes. The oppressive aspects of fathers. Just as hysterics have reminiscences, so do analysts. I think his father was his reminiscence, just as I think Kahn's father was his reminiscence. A very different reminiscence. So yes, it inhibited him. He couldn't say anything to his father. His father was a terrible pressure in a very English gent way.

FAYEK NAKHLA: And he grew up in a household of women, females.

JUDITH KUSPIT: And his wife was the one who observed how marvelous that household was. But his mother, of course, is the weeping, weeping mother of The Tree. [58] But she puts one line in her account of him, she says he paid a high price for that childhood. She may have known it.

MURRAY SCHWARTZ: So maybe the deficit he's using is not only maternal, but paternal also.

JUDITH KUSPIT: Yes, I think so. And that's why we don't see the fathers. I mean, Andre Green went to a conference for four days and said where's the fathers? Again, nobody's talked about fathers here. I think the father is in the larger environment. He's the muscle of the environment. The localized environment is the mother. It has a maternal identification. But the larger environment, there's some muscle in it. And I think that it's there. He doesn't fully articulate it. And late in life he just says a few things about the male. He says the first whole object the child meets is the male, is the father. And then he becomes a part object.

FAYEK NAKHLA: In his paper about the origins of creativity he describes the male element and the female element.[59] And the male element, he describes, as the “doing” and the female as the “being”. And Winnicott did do a lot of doing. No?

JUDITH KUSPIT: Yes. But you have to gather up being. He says that , for example, Guntrip, I think, had a lot of doing. But he never was able fully to gather up being and have a sense of it going; for it to keep on going. So he really has an existential point of view. You really have to be able to gather up being before doing. He doesn't have the conventional stereotypic idea that the woman can just “be” and the man has to “do”. It's not exactly that. AUDIENCE PARTICIPANT #1: Dr. Nakhla, in your presentation, you said that the analysis with Grace started when there's direct contact with the true self. Can you comment for us about this transition in the analysis from false selfness to true self?

FAYEK NAKHLA: As I described, I couldn't grasp her state of mind when she was silent at every session. I couldn't make sense of it. In my book --I'm very embarrassed because she describes a lot of these stupid things I did like insisting there's no such thing as [silence] -- I made her stand at the window and say or just talk about what you see. Just talk. But actually what made her break down is that she was held together by was a relationship with another woman. It wasn't a sexual relationship, but they were kind of an identity a’deux or something. They went to college together. They both kept diaries. They read each other's diaries. And when that relationship broke, when her friend, Susan, moved away, she came in and felt she wasn't connected to her body. And also because I didn't know what I was doing and she was describing this, that's when I put her in the hospital. At that point, even though I was familiar with Winnicott's false self and true self, something clicked when she was in the hospital. Fortunately I was in a position in the hospital to take charge of her treatment, rather than a resident taking over. Somehow I connected to that sense of falling apart, not existing, and so on. So I said something. In the session where she's tearing up the newspaper, I certainly am aware that she's torn up and the pot is really the false self containing her. Which she then handed over to me. She said I'm going to give you this. So I took over, which is what Winnicott says. It's only when the nursemaid or the false self that's containing goes out of the room. So we broke the pot together. And then we were left with her torn up self which went on for a few years in a very frightening way. All the things that Winnicott describes in terms of holding, I literally held her. At times she was just lying on the couch and I was holding her, but her leg was off the couch and she says it's like you have to contain every part of me. And I would allow her to cut herself. I mean she often came into my office and would cut. Sounds a bit crazy, but—

MURRAY SCHWARTZ: I think there is a feature of that moment that's a paradox. It's a very important feature. What you’re (addressesFN) talking about is something which is simultaneously real and metaphorical. I had an experience in analysis that I try to use to illustrate this. I drove millions of miles between Buffalo and Rochester because I was teaching in Buffalo and having analysis in Rochester, which gave me a kind of analytic space in the car. And I did this for a long time. And then at the end of a year I was driving on a very nice day and I looked up and the landscape was unfamiliar, strange. So I said to myself you must have gone passed the exit. I quickly thought if you go to the next exit and circle around, you won't be too late so keep going. So I kept going. A few minutes later I get to the exit and it's the right exit. So I got to my session, lie down on the couch and I said I just had this weird experience. I told what happened. My analyst just said one sentence. He said, “You thought you went too far.” Which, on one level, is just descriptive. But on another level opened up all kinds of things. And instantly, the second he said that, I remembered what I was daydreaming about when I looked up and saw the strange landscape; which was that morning I had received a letter inviting me to give a lecture that I was hoping to be invited to give and I knew there were other people competing for this. I felt very omnipotent and triumphant and I was having all these wonderful fantasies and I thought I went too far. How far can you go ? You know. When you're in strange territory and so on. So what was literal became both real and metaphorical, simultaneously.

FAYEK NAKHLA: Very good point, yes, yes.

AUDIENCE PARTICIPANT #4: I pride myself on being a practical analyst. I find these ideas wonderful to play with and the discussion is enormously stimulating. But what I find myself wondering, here we are, most of us are seeing people once a week. Many of the people we see do not have -- what was the phrase ? -- hallucinogenic minds. Many of the people we see do not work well with metaphor. Many of the people we see are not very literarily-minded. Likewise, many analysts don't fit that description but work in different ways. So I guess the question that I would put to you (the roundtable participants) is, in relation to theory and practice,-- I mean, there's no question that I think any good analyst integrates threads of these ways of thinking, helping patients connect with their real selves or true selves, if you will. And many other things that have been talked about today. Mutuality and so forth. -- but how far can we go with these ideas with so many of these people who we are treating today?

FAYEK NAKHLA: That's one reason when I was selecting my second supervisor and I was telling my training analyst-- I'm thinking of having Winnicott as my

second supervisor. And unlike the way she always would listen and say, why and what are your thoughts, her immediate reaction was “no.”( group laughter) Get a supervisor who will teach you psychoanalysis, the process and so on. But you see it's like your(addresses MS)therapist or analyst who just said “you went too far”. You know, it's like he's just mirroring something. Somebody else would make a big thing. Winnicott says the analyst who cannot play shouldn't be in the work, shouldn't do that work. Even reading ThePiggle, I said, you know, he's just allowing this patient to dream, The same way with the squiggle, I don't know anybody who does it. But Winnicott did that with children in Europe who didn't speak English. How can you relate to a child when you can't even introduce yourself or say a word ? He would just start making them dream and he’d get involved in it.

ELSA FIRST: See, I'm coming from, perhaps, an omnipotent place of feeling whoever walks in I'm trying to be alive with him , however flat or however unsymbolic they are. So I would ask ,how are you positioning yourself ? How are you restricting or focusing or what is it you're doing to yourself when you're facing the patient and you're saying I can just be practical here?

AUDIENCE PARTICIPANT #4: Well, I think what Professor Schwartz said about that intervention being both metaphorical and real we could say about every experience we have. I mean, the meaning of that experience, for the patient was obviously very important. And I think that every clinical moment that we are involved in has both a practical or -- I don't like to use the word real but I'll use it anyway -- a practical or real aspect of it- the patient screwing up his marriage, for example, and also a metaphorical meaning- the patient thinks his wife is his mother. And I think that what all of us strive to do is to find -- at least, I'll speak for myself because you put the question to me -- is to strike a balance between the practical and the metaphorical, to try to provide insight and understanding, deepen that and to show the relationship between the internal image, the object relationship and so forth and what is being enacted with the wife. But I also might intervene on a very practical level. I might slant my interventions in such a way that they might be inclined to lead to new action in certain instances rather than simply to deeper exploration.

ELSA FIRST: Okay, then we could question that polarity also. It reminds me of the old Jay Haley thing that change precedes insight. Which I was never totally happy with. If we are new objects, if we are in our struggle to engage that person in a way that is more alive and deep at the same time, then we are suggesting a different way of acting, in the room. It would be nice to have different people weigh in on this actually. If we're working with a split between the idea of helping people change their action,-- like, listen to your wife before you scream,-- and working on their listening to us in the room, say.

FAYEK NAKHLA: A couple of things maybe we can get from Winnicott regardless if we are going to do a Winnicottian analysis is his emphasis, especially later. We are always looking for clever interpretations, deep interpretations. We even change our voice when we are going into an interpretation. And he said, as he went along, he interpreted less, said less. The idea is he was really mirroring back to the patient the answer -- the situation comes from the patient, rather than our being active and interpreting.

AUDIENCE PARTICIPANT #1: Sorry to come up again. If I can resonate with my colleague [addressing audience participant # 4]. I was also analytically trained and I have a pretty heavy patient load and it comes up again and again that the patients that we see cannot experience us as a catalyst for deeper exploration and insight. So a lot of what we end up doing is we become teachers or rabbis about the psychoanalytic, the inner world process. The process of knowing, having connection to an inner world. And I guess that is the transitional space that we would like to hear your comments about.

MURRAY SCHWARTZ: I think this may have to do with a problem of common culture. I like to use a wonderful little example in the Psychopathology of Everyday Life [the second chapter of which I teach to undergraduates], the chapter on the forgetting of foreign words, where Freud analyzes the forgetting of a Latin word. He's walking with this young man, who may actually have been Freud, himself, who knows -- but on a vacation and they get to talking and a line from Virgil comes up and the young man can't remember -- he quotes it wrong. And Freud says oh, here's the right line. And he quotes the right line and he says you left out the word, aliquis, let's explore this. Imagine how much they have to have in common. Not in terms of education, but common culture and they both have Jewish histories and that's what's on their minds; and he can actually retrieve a line from Book Four of The Aeniad. Students are very impressed with this. So the whole thing is the illustration of the method is based on the fact that they have so much in common without which, they couldn't even begin the interpretive exchange. So maybe part of this issue is not just an empathic response, but finding some overlap in cultural experience. Finding a way in that would make for some kind of shared perception of what's real or what's important in the world. I think that's become more of a problem as people come from so many different places to analytic and therapeutic settings.

AUDIENCE PARTICIPANT #4: I will apologize like my colleague for getting up, yet again. I think maybe another way to think about this is in terms of analyst and analysand fit. I think Winnicottian analysts are a particular sort and I think that the patients that they work best with are a particular sort as well. I think that can be said about virtually any orientation and any patient. That's not to say that there's not overlap among categories. It's not a definitive assessment, but I think there are better or less adequate fits in therapist-patient pairs.

AUDIENCE PARTICIPANT #2 [responding to the prior audience participant #4]: I have to say this. I apologize for coming up again. (group laughter) I think maybe you’re more of a Winnicottian than you think. You’ll never remember this incident; but at the Institute we were discussing the issue of money in treatment and as we were leaving the Instittue I was very much into the specifics of that, the manifest content. I said to [AUDIENCE PARTICIPANT #4] “You know, my analyst not only made a big issue of money but when I gave him his check in an envelope he said, ‘why the envelope?’ and you said, “He knew something about you.”(group laughter)

AUDIENCE PARTICIPANT #5: I want to say thank you for this wonderful discussion. It's really exciting. I have kind of a comment or maybe I'm not sure if it's a question. But it kind of gathers up some of the things that the two of you (addressing JK and MS]were talking about earlier. In particular, the idea of the anxiety of influence and the collapse of potential space in the culture. I'm thinking about Winnicott's essay on the fear of woman[60], which nobody's talked about so far, and his idea in there that we all have a deep fear of woman, capital W-O-M-A-N, because we fear our ultimate dependence for life itself, on a woman. And that every human being is in infinite debt to a woman. In that article, he mentions that totalitarian regimes, people who gravitate toward cults, people who gravitate towards rigid thinking do so in order to defend against their dependence on a woman. So I was thinking about the collapse of the cultural space and the way that the imagination of the culture seems to have contracted in many ways, interestingly after a couple of waves of feminism. So is there some relationship between the collapse of potential space in our culture ,that I think is very evident right now ,and our struggle with the male and female roles in our society now?

MURRAY SCHWARTZ: Well, I'm thinking of the words that the young men when this question comes up, the words they use. It's not dependence. It's powerlessness. A sense of being lost. A sense that they can't make it on their own two feet. It may be very much related to what you're raising.

JUDITH KUSPIT: I think it's a brilliant question. I'm not exactly sure how to answer it. Historians, some of them, feel that men are at 1848 in terms of their consciousness, who they are . What it means to be a man. And they pick 1848 because it was the first wave of feminism. And that somehow they haven't gone through the second or the third wave, on some level, in terms of their consciousness of what it is to be a man. I'm not sure what to do with it, but I find working with young men fascinating just for this. We used to talk about the lost generation of women. You know, the lost weekend, the lost generation of women. We may have a lost generation of men just twenty-something who are in this situation. When Winnicott wrote that -- and that's a fascinating [article]-- I thought, God, this guy's right on the mark for all of us.

Freud once said that Rank and Ferenczi were peddling his theories, they were shortening psychoanalysis like salesmen in America and they were designing psychoanalysis for that. Winnicott and Masud Kahn had a conversation about the fact that Margaret Little had had this long, regressive analysis with him. People were cueing up to have that experience with Margaret and they felt that the experience [with her] was disastrous. And one of the reasons they felt neither men nor women could have this experience with a woman behind the couch was for just what you were talking about. He said we all have amnesia about the first years because of this terror of woman and it's almost like a pancreatic Christ or a primitive female, like the Bacchae. That we all have this image, both men and women.

AUDIENCE PARTICIPANT #5: That was actually the topic of my dissertation-- the fear of women. (group laughter) I'll make a leap over to the other comment about the existential anxieties that arose in the middle of the 20th Century or the way these things are rising to the surface; and one of the people that I fantasize Winnicott was influenced by and didn't cite was Paul Tillich, who was a theologian and wrote about the anxiety of being. And once again, “being” for Winnicott is the female element and “doing” is the male. Winnicott wrote about religion or God here and there. I just wonder, no one's brought that up. I wonder if there are any thoughts about this anxiety of being and the use of religion as a place to play and keep alive the transitional space.

FAYEK NAKHLA: He does include religion, culture, art, as all in the transitional phenomena , potential space.

JUDITH KUSPIT: He's not afraid of illusion and certainly Freud's relationship to religion was different than Winnicott's, where he embraces the illusion whether it's religious or otherwise. As you (addresses FN) said, he so rarely cited anything, it's hard to figure out whom he read. Because he said, don't give me anything to read because I rewrite it.

MURRAY SCHWARTZ: I think there may be two other technological or material factors involved. Since the '60s, there was a window of opportunity between the advent of the pill and the advent of AIDS. And now contributing to these male anxieties are technology - I might be actually irrelevant to the whole process, all you need is a sperm bank. You don't need a relationship. Cloning. And the other is AIDS, which is an underlying anxiety that pervades young people's lives.

FAYEK NAKHLA: I've been noticing there are more men in the waiting room where I work with some other colleagues. I don't know if you [addressing the group] experience that. But I always have that feeling if a man's coming into treatment, there's going to be more trouble than a woman.(group laughter) Because women enter into therapy much more easily.

MURRAY SCHWARTZ: I don't think it's an accident that you might say the fountainhead or origin of Western literature begins with the word ”rage.” That The Iliad is a poem about the management or mismanagement of rage. This is the great masculine issue. I think it still is a great issue. And interestingly enough, for all the language of aggression in Winnicott, hatred and so on, we don't find the word, rage, I don't think.

ELSA FIRST: I think destructiveness maybe the way we hear rage in Winnicott.

JUDITH KUSPIT: Well, it's interesting at the end of his life, Masud Kahn wrote an article about raising outrage to a primary emotion. He wanted analysts to take that seriously. Yes. And he worked from the French and he said that. And I suspect it was his primary emotion, particularly towards the end of his life.

SHEILA RONSEN: We have time for one more question or comment from the audience.

AUDIENCE PARTICIPANT #3: It's so interesting to me that so much is focusing on male issues with Winnicott whose focus obviously was so much on the infant-mother dyad. But wasn't the phrase, ”lost generation” from his generation in World War I? That was the lost generation. And he lost many classmates and friends in World War I and it's my understanding that he felt he had to live for them as well. Of course, the insight of the manic defense, I imagine, comes from his own experience of a manic defense against the depression of the loss of all of this. And the loss of the ideals of manhood from the Victorian and Edwardian ages and so forth. So I think it's so interesting that there's so little about manhood and masculinity in Winnicott. But he’s so evocative of these questions.

JUDITH KUSPIT: One of the things I found so fascinating were the notes he made before he died. He talks about the fact that he regrets that he didn't have a son that could kill and survive him. Right after he makes the prayer, ”May I be alive when I die,” he describes his bodily death. He’s an empiricist. He describes his own death by congestive heart failure. Then he says ,I got my wish. I was alive when I died. Then he goes on and says he regrets that he didn't have a son.

FAYEK NAKHLA: Or a child.

JUDITH KUSPIT: A child, yes. Then he says one of the things Lear didn't know was that Cordelia was his son. At the end he talks about these friends that he lost and he said that his “...being alive is a facet of some one thing of which their deaths can be seen as other facets: some huge crystal...”[61] I’m not sure what that means, whether it was a connection, but also, doesn't Stendahl have an image for love that's a crystal? I don't know whether it's that or not.

ELSA FIRST: Between him and the dead of the first World War?

JUDITH KUSPIT: Right, yes. I guess crystals form in the ground. I'm not sure what the image means.

ELSA FIRST: Do you want to read that piece where he describes his death?

JUDITH KUSPIT: I don't know if I have it.

ELSA FIRST: I have the book. (hands the book to Judith)

JUDITH KUSPIT: This is his prayer.(reading from the book) “D.W.W., Oh, God! May I be alive when I die.” Then Clare Winnicott writes: “Following these words, he started on the writing and it begins by imaginatively describing the end of his life and I shall quote his own words: I died. It was not very nice and it took a long time as it seemed (but it was only a moment in eternity). There had been rehearsals. (that’s a difficult word to spell. I found I had left out the “a”. The hearse was cold and unfriendly.) When the time came, I knew all about the lung heavy with water that the heart could not negotiate, so that not enough blood circulated in the alveoli, and there was oxygen starvation as well as drowning. But fair enough, I had good innings: mustn't grumble, as our old gardener used to say. Let me see. What was happening when I died? My prayer had been answered. I was alive when I died. That was all I had asked for and I had got it. (That makes me feel awful because so many of my friends and contemporaries died in the first World War, and I have never been free from the feeling that my being alive is a facet of some one thing of which their deaths can be seen as other facets: some huge crystal, a body with integrity and shape intrinsical in it.)” [62] That's it. Those are his notes.

SHEILA RONSEN: This is a good place to --

FAYEK NAKHLA: To end.

[1]Nakhla, Fayek,(1993) Picking up the Pieces, New Haven: Yale University Press

[6]Winnicott, D.W. (1977)The Piggle, An Account of the Psychoanalytic Treatment of a Little Girl. Madison,Connecticut:International Universities Press. “Piggle,” Winnicott explains in his Introduction, is a nickname, “ a term of endearment [in England] often used with young children.” The girl’s real name is Gabrielle but she was called “the Piggle” by her parents.